<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN"

"http://www.w3.org/TR/html4/loose.dtd">

<html>

<head>

<title>FORMUL&Aacute;RIO - MENSAGEM R&Aacute;PIDA</title>

<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">

<style type="text/css">

<!--

body {

	margin-left: 0px;

	margin-top: 6px;

}

.style8 {font-size: 12px; color: #FFFFFF; }

.style9 {color: #0000FF}

.style10 {color: #000000}

.style11 {color: #FF0000}

.style12 {font-size: 14px}

-->

</style>

</head>



<body bgcolor="#660000" text="#000000" link="#000000" vlink="#000000" alink="#000000" leftmargin="0" topmargin="0" marginwidth="0" marginheight="0">
<table width="98%" border="0" align="center" cellpadding="0" cellspacing="0" bgcolor="#FFFFFF">
  <tr> 
    <td width="77%" valign="top" bgcolor="#FFFFFF"><table width="100%" height="0" border="1" cellpadding="0" cellspacing="8" bordercolor="#FFFFFF">
        <tr> 
          <td colspan="2" bordercolor="#CCCCCC" bgcolor="#f0f0f0"><div align="center"><font color="#000000" size="2" face="Arial, Helvetica, sans-serif"><strong>CONTATO</strong></font></div></td>
        </tr>
        <tr> 
          <td width="54%" valign="top"> <div align="left"> 
              <p>&nbsp;</p>
              <p><font color="#FFFFFF" size="3" face="Arial, Helvetica, sans-serif"><font color="#333333" size="1"><strong><font face="Verdana, Arial, Helvetica, sans-serif">Rub-Rol 
                Rolos Gr&aacute;ficos Ltda. ME</font></strong></font></font></p>
            </div>
            <div align="left"> 
              <p><font color="#333333" size="1" face="Verdana, Arial, Helvetica, sans-serif">Rua 
                Visconde de Parna&iacute;ba, 2.311<br>
                Br&aacute;s - S&atilde;o Paulo - SP - CEP 03045-002<br>
                Tel: (11) 6292-5745 / Fax.: 6291-4601<br>
                </font><font color="#333333" size="1" face="Verdana, Arial, Helvetica, sans-serif">E-mail: 
                <a href="mailto:rubrol@uol.com.br">rubrol@uol.com.br</a></font></p>
            </div>
            <p align="justify">&nbsp;</p></td>
          <td width="46%" valign="top"><div align="center"> 
              <table width="150" height="71" border="0" cellpadding="0" cellspacing="0">
                <!--DWLayoutTable-->
                <tr> 
                  <th width="577" height="230" valign="top" scope="col"><form name="form3" method="post" action="http://www.guiadografico.com.br/cgi-bin/cgiemail/mens_rub_rol.txt">
                      <div align="right"> 
                        <table width="300" height="300" border="1" align="center" cellpadding="0" cellspacing="0" bordercolor="#F4F4F4">
                          <tr valign="middle"> 
                            <td width="79" height="22" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Nome: 
                                </font></strong></div></td>
                            <td width="234" bordercolor="#F4F4F4" bgcolor="#F4F4F4"> 
                              <div align="left"> 
                                <input name="nome" type="text" id="nome2" size="30" maxlength="40">
                              </div></td>
                          </tr>
                          <tr valign="middle"> 
                            <td height="22" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><p align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Empresa:</font></strong></p></td>
                            <td bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="left"> 
                                <input name="empresa" type="text" id="nome" size="30" maxlength="40">
                              </div></td>
                          </tr>
                          <tr valign="middle"> 
                            <td height="22" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Telefone(s):</font></strong></div></td>
                            <td width="234" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="left"> 
                                <input name="telefone" type="text" id="email3" value="(00) 0000-0000" size="15" maxlength="15">
                              </div></td>
                          </tr>
                          <tr valign="middle"> 
                            <td height="25" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Cidade/Estado:</font></strong></div></td>
                            <td height="0" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="left"> 
                                <input name="cidade" type="text" id="cidade3" size="20" maxlength="30">
                                <font size="2" face="Arial, Helvetica, sans-serif"> 
                                <select name="estado" id="estado">
                                  <option>AC</option>
                                  <option>AL</option>
                                  <option>AM</option>
                                  <option>AP</option>
                                  <option>BA</option>
                                  <option>CE</option>
                                  <option>DF</option>
                                  <option>ES</option>
                                  <option>GO</option>
                                  <option>MA</option>
                                  <option>MG</option>
                                  <option>MS</option>
                                  <option>MT</option>
                                  <option>PA</option>
                                  <option>PB</option>
                                  <option>PE</option>
                                  <option>PI</option>
                                  <option>PR</option>
                                  <option>RJ</option>
                                  <option>RN</option>
                                  <option>RO</option>
                                  <option>RR</option>
                                  <option>RS</option>
                                  <option>SC</option>
                                  <option>SE</option>
                                  <option selected>SP</option>
                                  <option>TO</option>
                                </select>
                                </font> </div></td>
                          </tr>
                          <tr valign="middle"> 
                            <td height="22" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">E-mail:</font></strong></div></td>
                            <td bgcolor="#F4F4F4"><div align="left"> 
                                <input name="email" type="text" id="email3" size="30" maxlength="50">
                              </div></td>
                          </tr>
                          <tr valign="middle"> 
                            <td bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Assunto: 
                                </font></strong></div></td>
                            <td height="22" bordercolor="#F4F4F4" bgcolor="#F4F4F4"><div align="left"> 
                                <input name="assunto" type="text" id="assunto3" size="30" maxlength="50">
                              </div></td>
                          </tr>
                          <tr> 
                            <td height="75" bgcolor="#F4F4F4"><div align="right"><strong><font color="#000000" size="1" face="Verdana, Arial, Helvetica, sans-serif">Mensagem:</font></strong></div></td>
                            <td height="75" bgcolor="#F4F4F4"><div align="left"> 
                                <textarea name="mensagem" cols="25" rows="5" wrap="hard" id="mensagem"></textarea>
                              </div></td>
                          </tr>
                          <tr bordercolor="#F4F4F4" bgcolor="#F4F4F4"> 
                            <td height="26" colspan="2"><div align="center"> <font size="2" face="Arial, Helvetica, sans-serif"> 
                                <input name="success" type="hidden" id="success2" value="http://www.rubrol.com.br/resposta.php">
                                </font> 
                                <input class="form_botao" type="submit" name="enviar" onClick="feedback(this.form);return false;" value="ENVIAR">
                                <input name="reset" type="reset" id="reset2" value="LIMPAR">
                              </div></td>
                          </tr>
                        </table>
                      </div>
                    </form></th>
                </tr>
              </table>
            </div></td>
        </tr>
      </table></td>
  </tr>
</table>
</body>

</html>

